# MEC DENTAL II, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447447461
- **Authorized official:** MRS. KRISTINA D GRAY (OFFICE MANAGER)
- **Authorized official phone:** (317) 491-0188

## Contact information

- **Practice address:** 820 E 53RD ST, ANDERSON, IN 46013-1731
- **Practice address phone:** (317) 491-0188
- **Mailing address:** 13606 CREEKRIDGE LN, MC CORDSVILLE, IN 46055-9599
- **Mailing address phone:** (317) 491-0188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 12010045 | IN | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 10/04/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 12010045 | LICENSE | IN |